Increased Mortality After Prosthetic Joint Infection in Primary THA

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Public Health

Background:

• Prosthetic joint infection (PJI) following total hip arthroplasty (THA) significantly impacts patient health.
• The mortality risk associated with early PJI after primary THA remains unclear.

Purpose of the Study:

• To compare mortality risk in patients undergoing revision for PJI within one year of primary THA versus those without revision.
• To compare mortality risk in patients undergoing revision for PJI versus aseptic revision.
• To identify specific bacteria associated with increased mortality in PJI patients.

Main Methods:

• A population-based cohort study utilizing the Danish Hip Arthroplasty Register (2005-2014).
• Linked data from microbiology, patient registers, and civil registration systems for comprehensive patient information.
• Compared mortality risk in patients revised for PJI within one year to those without revision and those with aseptic revision.

Main Results:

• Patients revised for PJI within one year of THA had an 8% mortality rate.
• The adjusted relative mortality risk for PJI revision was 2.18 compared to no revision (p < 0.001).
• PJI revision carried a 1.87 times higher mortality risk than aseptic revision (p = 0.019).
• Enterococcal THA infections were associated with a 3.10-fold higher mortality risk (p < 0.001).

Conclusions:

• Revision for PJI within one year post-THA significantly increases mortality.
• Further research into PJI prevention and risk stratification is crucial to reduce mortality.
• Findings emphasize the need to mitigate mortality in THA patients, particularly those with PJI.